Your Health & Happiness:
Foreigners in Thai hospitals - the pleasure and the pain
By Noel Bruyns
Foreigners who fall ill and are admitted to hospitals in
Thailand may experience a certain amount of trepidation. Thai nurses and
doctors, in turn, also often struggle with the culture shock of treating
patients from overseas.
That is why Bangkok-Pattaya Hospital (BPH) turned to the
Thai-German Institute (TGI) based in Pattaya to ask for help in dealing with
and understanding German - and other foreign - patients better.
The result was a seminar for medical staff conducted at
the hospital by Dr Eberhard Stockmann, director of the medical department of
Siemens in Erlangen, Germany on June 30. He also travels around the world
where Siemens employees are working to liaise with clinics.
Among other topics, Dr Stockman explained the German
health system, Siemens’ medical care for people who are sent abroad and
what kind of treatment Germans expect.
“There is no significant difference in the
technological knowledge between Thai and German doctors,” he said,
referring to the quality of treatment at international hospitals in
“In fact, many people abroad come to Asian countries
for check-ups and treatment, because the quality of treatment is the same as
in their home country, but much cheaper - and they can throw in a week’s
holiday as well,” he noted.
A significant difference that Dr Stockmann pointed out
for the BPH medical staff’s attention is that in many European countries,
ambulances that are sent out on emergency calls are not only fully equipped
but also include a doctor on board. “This is so that you don’t have to
wait until the patient is brought back to the hospital to be treated in
TGI expert for Occupational Health, Safety and
Environment Karsten Deckert, speaking of his “cross-cultural experience in
receiving medical treatment as a German with a Thai passport”, observed
that hospitals and medical staff in Thailand are more customer-orientated.
“Hospital rooms are like hotels where spouses can stay
in private wards, if required. This would be impossible in German
TGI German director Walter Kretschmar also remarked on
the personal care, warmth and “jai” (heart) in Thai hospitals “which
we miss in Germany”.
However, he pointed out personal experiences that
highlighted differences in approach. Going to a Chonburi hospital with ear
ache, the doctor simply gave him an assortment of pills without explaining
the ailment or the medication.
“I didn’t take the tablets because I didn’t trust
the treatment,” he confessed. “Back home, patients want to know exactly
what is wrong with them, and detailed information about the medication.”
When he was TGI safety officer, he asked his secretary to
buy a first-aid kit for the office.
“She came back with a pile of pills. The Thai
understanding of first-aid is culturally different. I had to go out myself
to buy items that included plasters, scissors and a fridge - not for the
milk or cake for the office - but to put the first-aid items in it” so the
tropical heat would not ruin them, he explained. “They thought I was a
crazy guy,” he quipped.
Kretschmar congratulated international and urban
hospitals in Thailand on their quality, but said he had experienced
hospitals in more remote areas that were “shocking and unhygienic”.
However, he also remarked on the typical positive
attribute of Thais. “Your smile is very valuable, psychologically, for the
healing process,” he said.
* TGI describes itself as the largest and most advanced
independent training center for industrial technologies in Thailand.
“With German-backed quality principles, state-of-the-art equipment and
highly-trained staff, we offer a real opportunity for Thailand’s
technicians and engineers to improve their qualifications and keep
up-to-date with the most advanced techniques and technologies,” the TGI
The Doctor's Consultation: The hewers of stone and the drawers of water
by Dr. Iain Corness
In the medical business, Urologists are sometimes called
the hewers of stone and drawers of water, because much of their work deals
with kidney stones and assisting men to be able to pass water adequately. We
men do suffer at times; it’s not only the ladies who have ‘specific’
Your urinary system is a remarkable collection of organs,
beginning with the kidney, the “super filter”. The kidney filters the
blood and allows the important stuff like blood cells and nutrients to
continue waltzing around your circulation, but taking out the nasties, and at
the same time helping balance the acidity/alkalinity of the body. Clever
little organs, the kidneys!
To keep your kidneys in top shape does not require special
kidney exercises, you will be pleased to know. In fact, there is nothing you
can do ‘physically’ to make the kidneys perform, but fortunately there are
some things you can do to keep them in top condition.
The first is to drink plenty of water every day. And by
‘water’, I mean the plain and simple H2O, not the stuff that has been
mixed with hops, distilled with grain or left to age in oak casks. Making the
kidneys exercise, to filter and regulate the circulating blood volume, is
simply carried out by drinking several litres of water every day. Yes, it is
that easy. On your desk at work keep a glass of cold water beside you and
empty it every 30 minutes.
The advantages you get from this are enormous. First off,
you have immediately lowered the chances of forming kidney stones, a
potentially dangerous (and painful) condition. Being a card carrying coward, I
have always preferred the drinking water option to the lying in bed groaning
with pain alternative. In fact, around 15 percent of people will experience
stones in their lifetime (especially in the hot climates) and men outnumber
women between two to three times. We also know that if you do not change your
lifestyle, you are very likely to develop another stone within two years after
the first episode. We men do suffer at times, it’s not only the ladies who
have ‘specific’ problems!
The kidneys drain to the bladder by two tubes called
Ureters. These do not do much, other than connect the kidney to the collecting
vessel (bladder). However, if a piece of stone gets stuck, you will soon know
about it. Renal colic sorts out the men from the boys! Ultimate pain!
From the bladder, the urine gets introduced to the outside
world by another tube called the Urethra. This is short in ladies and is the
reason that women get Cystitis (bladder infections). It is longer in the men
folk, allowing us to stand up to pee and become obsessed with how long or
short it really is.
However, we chaps have another problem in that region, as
far as getting the urine from the bladder to the far wall of the urinal. This
is called the Prostate, and it encircles the Urethra and when enlarged, closes
down the internal diameter of the pee tube. This makes it difficult to pass
water and you dribble on your shoes. The prostate can also become cancerous,
an even less pleasant state of affairs. We men do suffer at times, it’s not
only the ladies who have ‘specific’ problems!
Yes, you can have a check-up for this area too. Just ask to
see the hewers of stone and drawers of water!
I read in the Chiangmai Mail that the bar girls are worrying about
the health of the local buffaloes, because if they are all replaced by
tractors then the pleading “buffalo sick, send money” won’t work any
more. I have got a letter asking for money to pay vet bills for a Thai
girl’s family buffalo. Is this really true? Are they that devious?
Dear Buffalo Bill,
I could have answered your letter with just one word - Yes! However, like
all begging attempts, it is up to you what you do. When you go across the
pedestrian footbridges in Bangkok, there will be somebody, usually with a
rented baby at the breast or an obvious physical deformity, with a begging
cup at each stairwell. You can give, or keep your money firmly in your
pocket. Likewise the begging letters, which all have a fairly common
source, in fact there is a book published for bar girls to learn English,
that has a basic pro-forma letter of the type “Dear Blank (fill in name
of sucker, sorry, boyfriend), I miss you so much. Unfortunately I have to
tell you that I will have to go back to working in the bar because my
mother/brother/father/baby/buffalo (delete whichever are inappropriate) is
sick. If you could send $$$$$ (fill in the amount wanted) then I could
just stay here in our flat and wait for you. Life is not the same without
you (or without your wallet). Your loving girlfriend (Sai, Sim, Toy, A,
Bee, Dee, Nud, Nid - delete whichever is inappropriate). Yes Buffalo Bill,
I think you should keep your money in the bank at Wounded Knee and wait
for the Cavalry. The buffalo will look after itself. You don’t need to.
My computer is behaving worse than any woman I have ever met. It can be
all sweetness and light one day, and just as suddenly change and become
impossible to work with. It will work sometimes, and for no apparent
reason just change its mind and stop working. The screen can be a lovely
sunny sky colour and in the blink of an eye it turns into a horrible deep
storm blue. Have I just got a bitch of a bug, or do you think this is some
female plot? Before I jump on the damn box of tricks, or punch the
screen’s lights out, have you any suggestions as to what I should do?
I’ve had everyone look at it, but nobody seems to know how to make it
behave. I’m at my wits end.
Dear Computer Charlie,
What do you think Hillary is? A computer repairman? I mend broken hearts
or give advice to the lovelorn, Petal. I don’t mend computers. I hate
computers as much as you do. If the car companies sold cars that would
stop for no reason, crash despite all your good efforts, and race off and
do illegal things behind your back, they would be out of business in no
time. Yet somehow the boss of the (guaranteed to fail) operating systems
ends up as the richest man on the planet. Charlie, there is no justice in
the world, or otherwise Hillary would be sitting sunning herself around a
six star swimming pool, while sipping French champagne and nibbling
Belgian chocolates surrounded by attentive waiters. However, I do think
you should do something about that temper of yours. You can’t go round
threatening to punch people’s lights out, just because they won’t work
the way you want them too!
I have been holidaying here in Thailand for three months and will be
returning to my country for around four months, before coming back. I am a
single male and have formed a steady relationship with a young woman here.
She has a regular job and is not employed in the entertainment industry,
if I can use so loose a term. I would like to give her something to remind
her of me while I am away. Have you any suggestions on what I should get
for a young Thai lady in her late twenties? We have not been living
together and up till now it is a real ‘friend’ situation, though I am
looking to make this into something more when I return.
Regular guy Ron
Dear Regular guy Ron,
First, I am very happy that you want to give your lady friend a gift to be
a token of your feelings for her while you are off overseas. That is very
sweet and thoughtful of you, Petal. The best kind of present is one that
she would use every day, and when using it, this would bring you to mind.
Have you thought of a nice leather money purse/wallet, complete with a
photo of you (and her) inside? This is something that she would use every
day, and would hopefully bring a smile to her face each time. However, it
is probably more important for you to tell her what you have told me,
where you say that you are looking at making the relationship “something
more” when you return. Good communication is the most important factor
in all relationships.
Camera Class: How to make the subject jump off the print
by Harry Flashman
What is the most commonly photographed subject? No, it is
neither elephants nor local politicians, but is most likely a person you know.
Be that wife, parents, children or country cousins, the main subject for the
majority of amateur photographers is people. Take a look at your photo albums if
you don’t believe me. For many of these photos they are of the type, Mum at
the zoo or Auntie Mame at the beach, or Uncle Walter in Chiang Mai.
What you have to consider is “why” you are recording this
1/60th of a second in time for posterity. When you realize “why” - your
shots will improve.
It is simple really - in actual fact, you are recording a
time “when” your relative was “in” a particular place. Consequently, you
have two important items to show in the shot - “who” and “where”.
Take “where” first. This is the background to the shot,
and in many ways a most important item. While you may know that the shot was
taken in Chiang Mai, nobody else does, and certainly not in a few years time,
unless there is something in the photograph that relates to the location.
So rule number one is to make the background “specific”
for the location. Mum with a giraffe probably does mean a zoo somewhere, but a
sign always helps to pinpoint the location. Likewise with Uncle Walter in Chiang
Mai. Get somewhere in the city that either says Chiang Mai, or use some local
landmark that is unmistakable, like the moat in Chiang Mai or the bay in
Pattaya. Look at this week’s photo with Pattaya Bay giving the location for
Now remember that after you have found a good background
location, you have to stick a person in it too, and the concept here is not to
make the subject (Mum, Auntie Mame, Uncle Walter) part of the background. You
have to well and truly separate the two. The subject is the “hero”, so bring
the subject up close. Rule number two is to bring the subject away from the
background, to make sure the subject is the principal item of interest.
What you do now is to juggle the two items around so that you
get the best shot possible. Try taking one shot where the subject is central,
and the background extends on both sides. The next two shots should be taken
with the subject 1/3rd in from the left border for one and similar placement in
from the right border of the shot for the second photo (back to the Rule of
The thirds tip is to look at the background before you pop
the shutter button. This requires you to practice looking through the viewfinder
with the critical eye. It means that you look beyond the breathtakingly
beautiful model posed before your lens and stretch your focus through to the
background. Now look for contrasts.
This simply means to have a light background if the person
you are shooting has dark hair, and the reverse for those with blonde or white
hair. Now to get this may require you to move the model, move yourself or move
the location again. This is worthwhile. No matter how good the shot looks as you
try so diligently to get pinpoint focus on your subject - if there is no
contrast between subject and background you will be disappointed in the final
photograph. The person’s hair will disappear into the background. This is
especially so when photographing the very dark haired people of Thailand. Just
look at some of the social page photographs in this issue of the Mail and
you will see just what I mean.
Probably the last item to consider is colour. When all else fails, or is
impossible, position your subject against a contrasting coloured background. A
yellow dress in front of a red door, for example, will always stand out. Blue
and white are also good contrasts. And of course, never forget black and white!
Dr Byte's Computer Conundrums
by Dr Byte, Citec Asia
Last issue, we looked briefly at the almost daily problem
with internet connections to the outside world. So what is actually going on and
what can we do about it?
Obviously if you cannot connect or your web page hangs, a
download or upload stops in the middle, something has happened. We can even see
if the tiny little dialup monitor in your system tray, kindly provided by
Microsoft, stops winking. But there have to be more accurate methods of checking
The first problem is to be able to detect when the connection
drops out. I am sure none of us sit there watching the connection monitor all
day. We need an audio or visual signal of some kind to alert us if the
connection drops out. Low bandwidth internet radio is a simple answer. If the
music stops, the internet connection has stopped for some reason. Winamp gets 4
stars because you can select the bandwidth for radio stations and has a simple
and easy interface.
The second problem is to be able to monitor what is actually
happening between our computer and a destination. For example, what happens when
we connect to www.TheHostServer.com in the USA.
There are many simple and not so simple net monitor
applications and the best of the best is 3D Trace. It’s free and gives a very
effective 3D display that cleverly shows how many jumps (servers), who, where
they are and how long it took. The result visually looks like a 3D Graph and we
can see straight away whether the internet is working or not working. Go to
http://www.hlembke.de/prod/3dtraceroute/ download now and start using it. Simple
to install and has some very useful tools (synchronise PC time, WHOIS, DNS
lookup and so on) and is the only application I have ever given a 5 Star rating
While 3D Trace is very, very good, you can only monitor one
destination at a time. To monitor several destinations at a time, such as watch
and compare your ISP’s (Internet Service Provider) Chiang Mai gateway, track
the Bangkok Gateway and even monitor your own intra-net (between your computer
and a server) you need a different application. There is another simple product
called Ping Monitor and it’s also free and available from
www.express-soft.com/pingmon/ and this gets 3.0 stars and needs more advanced
knowledge to run.
These applications make it very simple to monitor what’s
happening and know that something is simply not correct when you telephone
Customer Support and they claim nothing is wrong.
What choices do we have to connect anyway? The answer is
broken down into groups of connection options to make it easy to compare
Dial-Up Modem: There are plenty of offerings here, but all
suffer from the same antique telephone system that still uses 50-year-old
telephone lines and analogue telephone exchanges. More of an issue outside the
major city areas, the rest of us have a plethora of choice and decisions we can
While your PC may be reporting a connection of 44-48K (the
connection speed), and modern computers usually have the latest 56K modems, I
guarantee the reality is significantly less as signal strength is degraded by
poor line quality and so on.
Web Connection Kits vary widely but two examples include the
Inet Access Kit, 500 baht (as low as 5 baht per hour after office hours) and
CSLoxinfo’s Biz Kit 30 providing 30hrs for 720 baht. Don’t forget that most
ISP’s here and overseas use a ratio of 9:1 when they set up modems for users
to connect through. That’s why at peak times, you only get online after
dialling a few times. For every 9 of you, there’s only 1 modem.
The other thing people constantly complain about is, after
spending 30 mns getting on line, the connection hangs after 10 seconds. This is
usually caused because you connected to a faulty modem or this could also be
caused by Thai Internet connections to the outside world. Dial-up modem gets a
2.5 star rating (because the infrastructure is so old). I am amazed how many of
us still rely on it.
Tip: Those of you living outside the city area should
consider slowing your modem connection speed to 28K or 33K. Believe me it works
and I will explain why another time.
In the next issue find out about your options and see if
there’s a solution for you. Are there any reliable ISPs and is one better than
If you have any tips or tricks that you’d like to share, or
any questions about your internet or pc experience, contact me: Dr Byte,
Beer and More: Drink beer and live longer
by Karl Eichhorn,
Chiangmai Malting product manager
Beer is a beverage which is produced from water, malt, hops
and cultured yeast, the latter to stimulate fermentation. Beer has been known to
mankind for 6000 years. Of all the beverages produced worldwide, beer is the one
consumed most. In 2000, the world production peaked 1.392 million hectoliters.
Nearly 20 years ago, Prof. A. Piendle of the Technical
University Munich emphasized the importance of links between beer consumption
and health. His conclusion was, however, largely ignored. Only during the German
brewers meeting (Deutscher Brauereitag) in 1997 this connection appeared as a
What many scientists had assumed for a long time appears to be supported by
are hops before they combine with malt and water and become the delicious
refreshing drink we call beer.
Beer is not only a wonderful means to quell the thirst. Its
content of vitamins B1, B2, B6 and A, D, E and K improves man’s ability to
concentrate, stimulates his metabolism, supports the production of red blood
cells and influence positively blood circulation and nerve system.
The same can be said of the beer’s mineral content, which
also affects muscles and the work of hormones. A glass of beer is the best
remedy against nervousness and stress. It is the beer’s content of hops which
tranquilizes agitated nerves, while its carbon dioxide and the low content of
alcohol help the relaxation of tense muscles.
After comprehensive research, scientists of the Technical
University of Munich concluded that life expectancy of men who drink beer in
modest quantities is higher than that of abstinent people. They claimed that
those consuming no alcohol at all are the ones least satisfied with their state
Let me end with some anonymous words of wisdom that reflect my way of life,
“Everybody should believe in something - I believe I’ll have another
Money Matters: Storm Watch Update Part
Gold and Silver Fundamentals - Based on a an article by Jim Puplava March 2004
MBMG International Ltd.
4) Increased Demand
The fundamental supply and demand picture for gold has
begun to deteriorate. Demand is rising while supply can no longer keep up
with demand. According to Gold Fields Mineral Services demand for gold rose
4% globally last year while supply increased by only 0.4%.
The demand for gold is changing from one of industrial
demand to one of investment demand. Higher prices have curtailed jewellery
demand while investment demand is flourishing.
As prices have risen, fabrication demand has fallen from
3,782 tonnes to estimated demand of 2,822 tonnes this year. Primary demand
has fallen, while investment demand has accelerated; disinvestments of 358
tonnes in 2000 to estimated demand of 565 tonnes this year, a turn around in
demand of 923 tonnes.
A summary of the GFMS report for last year reveals the
following: Gold demand rose 4% year over year; Producer de-hedging fell by
27%; Jewellery demand fell by 7%; Mine supply increased by less than 1% and
Investment demand has risen by 328%. Over 50% of the industry’s 3,000
hedge position has been eliminated over the last three years.
Despite the recent run up in the price of gold there
remain two wild cards regarding gold; they are official sector gold sales
and the gold derivative book of money centre banks in the U.S. and in
Europe. Central banks could try to drive gold prices down by dumping their
gold but the Washington Agreement places a limit on these sales. The
agreement can be circumvented through gold leasing. However, the question of
the amount of gold left to sell in central banks is far less than where it
was in 1994.
There are professional estimates that believe that more
than half of all the gold of central bank vaults no longer exists. It has
been sold or lent out. The other wild card is the derivative position of
money centre banks both in gold, currencies, and in interest rate swaps and
contracts. The current derivative book of money centre banks has mushroomed
to $67 trillion as of the end of the third quarter of last year. The gold
derivative position of money centre banks is currently $85 billion - a
figure that hangs over a much smaller physical market. Nobody knows for sure
which way these contracts swing. It doesn’t matter whether they are long
or short, if prices spike up or down in the opposite direction. When you are
this leveraged there can be a major problem. If rates rise or the price of
gold goes parabolic like silver has done recently, then “Houston we have a
This could become a major wild card that could send the
price of bullion and bullion shares soaring if or when it erupts. The
problem is when you are this leveraged, you are always unprepared for the
unexpected. History shows us that the fat tails of the bell shaped curve
recently have been reoccurring with greater frequency. It is the fat tails
and not the belly of the curve that we should be concerned about.
5) Low Negative Interest
The return from short -term interest rate vehicles is no
longer high enough to compensate an investor for inflation. The rate of
return on short-term Treasury paper is as follows:
The rates shown above are far below the current rate of
inflation. This means that an investor is actually losing ground on
short-term paper investments. The interest rate offered isn’t commensurate
with the rate of inflation.
According to the recent PPI report here in the U.S.,
producer price inflation is running at an annual rate of 7.2%. Commodity
price inflation as reflected in the price of the CRB Index is running at an
annual rate of 7.7%. The price inflation of food and energy - commodities
that we need and consume daily - is running in the double -digits.
It is clear that interest rates this low are clearly
signalling the destruction of the value of financial assets. Interest rates
this low are a sign of monetary inflation. This is good for gold. Interest
rates this low reduces the contango in the futures market which is also good
for gold. Low interest rates are gold bullish.
6) Volatile Geopolitical
Pick up the papers, turn on the evening news, or read a
news magazine and tell me what you see ... war, assassinations, political
coups, bombings, and worldwide terrorist attacks. These are just a small
sampling of (that day’s) headlines out of Bloomberg: Israel kills Hamas
chief Yassin; Hamas vows revenge; Pakistani army convoy attacked in
North-western tribal region; UN envoy calls for calm in City of Heart where
100 people were killed; Bush will ask Congress to increase U.S. troops in
Columbia by 75%; Fighting in western Nepal kills 130.
These headlines are not out of the ordinary. The
headlines listed above seem to be a daily faire in global news. Terrorism is
on the rise and most western governments seem powerless to stop it.
Bombings, assassination attempts, low density conflicts (LDCs) are all part
of the world we live in. As conflicts increase the rise in the price of gold
and silver become a barometer of not only fear, but also a lack of
confidence in world leadership.
Rising global budget deficits, an expanding world money
supply, resource scarcity and resource wars are all part of today’s
present political climate. When fear abounds, gold astounds. The present
global conflict is very much reminiscent of the global conflicts, trade wars
and depressions of the 1930s. This time around there is far more debt, a
larger supply of fiat currency, greater political tensions, and a shortage
of natural resources to meet economic and population growth. Today’s
modern weapons of war are more lethal. Our modern nuclear weapon systems, as
well as our modern financial weapons of mass destruction: derivatives, are
capable of wrecking far more havoc, tragedy, and destruction than all of the
history of mankind.
Geopolitical storms are joining together with financial
storms and are causing greater volatility and political mishap in the
world’s financial markets and in the halls of government. It is just one
more reason why the price of gold and silver are heading higher. (For
further reading of this new political environment see PowerShift: Money, Oil
The above data and research was compiled from sources
believed to be reliable. However, neither MBMG International Ltd nor its
officers can accept any liability for any errors or omissions in the above
article nor bear any responsibility for any losses achieved as a result of
any actions taken or not taken as a consequence of reading the above
article. For more information please contact Graham Macdonald on graham@mbmg-inter